Soyfoo Muhammad S, Catteau Xavier, Delporte Christine
Department of Rheumatology, Erasme Hospital, 808 Route de Lennik, 1070 Brussels, Belgium.
Int J Rheumatol. 2011;2011:302527. doi: 10.1155/2011/302527. Epub 2011 Aug 7.
Sjögren's syndrome (SS) is an autoimmune disease characterized by keratoconjunctivitis sicca and xerostomia. There are actually no diagnostic criteria for SS, but classification criteria based on the revised American-European criteria have been elaborated. These include subjective criteria: ocular and oral symptoms, and objective criteria: ocular, histopathological, oral, and serological signs. SS is considered if 4 of the 6 criteria are present, when histopathology or serology is positive, or if 3 of any 4 objective criteria are present. A patient presented with both ocular and oral symptoms and signs but did not meet the SS classification criteria. Indeed, no anti-SSA or anti-SSB antibodies were detected, and minor salivary gland biopsy was normal. To further understand the origin of the sicca symptoms, a parotid gland biopsy was performed and showed important lymphocytic infiltrates. This could account for the sicca symptoms and signs since parotid glands are one the major contributors to salivary flow. Therefore, parotid gland biopsy could be a useful asset for the diagnosis of SS.
干燥综合征（SS）是一种以角结膜干燥症和口干症为特征的自身免疫性疾病。实际上，目前尚无SS的诊断标准，但基于修订后的欧美标准制定了分类标准。这些标准包括主观标准：眼部和口腔症状，以及客观标准：眼部、组织病理学、口腔和血清学体征。如果满足6项标准中的4项，组织病理学或血清学呈阳性，或者满足任何4项客观标准中的3项，则可诊断为SS。一名患者同时出现眼部和口腔症状及体征，但不符合SS分类标准。事实上，未检测到抗SSA或抗SSB抗体，小唾液腺活检结果正常。为了进一步了解干燥症状的起源，进行了腮腺活检，结果显示有大量淋巴细胞浸润。这可以解释干燥症状和体征，因为腮腺是唾液分泌的主要贡献者之一。因此，腮腺活检可能是诊断SS的有用方法。
